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Is stockpiling pandemic flu drugs shrewd or misguided?

IS STOCKPILING flu drugs for a possible pandemic a waste of money? Last week, medical journal BMJ and the Cochrane Collaboration, an independent network that reviews medical evidence, repeated claims that it is.

They made similar charges in 2009. Both are based on studies of relatively mild winter flu, not the severe pandemic virus for which stockpiles are intended.

In 2009, the pair complained that all the results from human trials of Tamiflu, made by Roche, weren’t freely available. Drug firms only show all such data to regulatory agencies – although European regulations will soon ensure that all firms make their data on new drugs publicly available. Roche has now released all the Tamiflu trials data, making this the first review of such a comprehensive data set.

The review showed that Tamiflu reduces the bacterial pneumonia that can follow winter flu. But when Cochrane excluded 15 of the 20 studies because pneumonia was “self-reported”, there were too few patients to show whether the drug worked. Cochrane used this to conclude that there is “no good evidence” that Tamiflu works.

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The UK has stockpiled £424 million worth of Tamiflu, and the US has a similar stockpile worth &dollar;1.3 billion. Both need renewing.

Cochrane reviewed only studies in which people got either the drug or a placebo. Such trials can’t involve the severe viral pneumonia for which the drugs are especially needed in pandemics, as you can’t give critically ill people a placebo, says Jonathan Van-Tam of the University of Nottingham, UK.